HomeMy WebLinkAbout2000 Info Discl req. ORONO ADMINISTRATIVE OFFICES
INFORMATION DISCLOOStRE PRACTICESQST
ACT
MINNESOTA GOVERNMENT
•
REQUESTER NOTE:
A. Request Frequency - Private Data on individuals. After the
ou
daeed not supplied
losed to youdata and f fored sixfits monthsethereafter
data needanot ending or additional data -on
unless a dispu�e or action is p
you has been collected.
B. You may be required to pay actual costs in making,
certifying and/or compiling the copies of information_
requested. /S-- ---
Date of Request: --7 Z- )
Requester Name:
ce s' w ij ' c <Se�i/
y`7 -T-- 61-a#am"vi ; 'n.?;'/�
Address: / •�' City: /
-
Zip:
Home Phone: y 7 / ._7C t
Business: `- e-.2___
Description of Information Requested:
•
Requester'. s Signature:
BELOW INFORMATION TO BE FILLED IN BY DEPARTMENT ONLY
Handled By:
Depart cent=
Mail Phone
Request Type: In person
Requested By:
Subject of Data Not Subject of Data
Tnformation Requested is Classified.:
Public Private
Confidential
Non-Public Protected Non-Public
Request is: Aooroved
Denied P_nproved in_part
Remarks/Comments:
Authorized Signature:
Fees:. xTotal Due
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